52 PERSONAL APPEARANCES IN HEALTH AND DISEASE. 



organ called the thyroid body situated immediately below 

 the prominence in part of the neck, known by the name 

 of " Adam's apple," and consisting of two lobes con- 

 nected by a narrow isthmus, which passes across the air- 

 passage, the lobes lying one on each side of the voice 

 organ or larynx. By its enlargement, which often is 

 excessive, there ensues a large prominence in front of the 

 neck, this is the wen or " goitre," frequent in Derbyshire 

 and in many parts of Switzerland and France. 



The size of the chest, as we have said, is ever changing. 

 It enlarges as the lungs expand, and contracts as they 

 empty. Its form and dimensions also largely depend 

 upon the condition of these organs. If they remain from 

 birth not fully inflated, there is corresponding smallness 

 in the form of the chest itself. If on the other hand 

 they are of large size, and unusually capacious, the 

 thorax is large, broad, and deep. The change in shape 

 which the chest undergoes during respiration is as 

 follows-, with inspiration the diaphragm descends, that 

 is to say, becomes less convex towards the chest; and 

 the lateral walls of the chest are enlarged by the 

 ribs being raised by means of certain muscles passing 

 between them, and the upper ones by-muscles going from 

 the spine in the neck to the upper rib, and also slightly 

 everted, this latter action being most marked in the 

 lower ribs. An elevatory movement combined with one 



